The nurse is caring for a client who suffers from frequent blood clots and is currently taking argatroban. Which of the following conditions in the client's medical history would require them to take argatroban?
Heparin induced thrombocytopenia.
Ventricular Dysfunction
Myocardial infarction
Hepatotoxicity
The Correct Answer is A
A) Heparin induced thrombocytopenia (HIT): Argatroban is an indirect thrombin inhibitor specifically used for anticoagulation in patients with HIT. This condition involves a significant drop in platelet counts due to heparin therapy, and argatroban is an appropriate alternative for preventing thrombosis in these patients.
B) Ventricular Dysfunction: While managing anticoagulation may be important in patients with ventricular dysfunction, this condition does not specifically necessitate the use of argatroban. Other anticoagulants may be used based on the clinical situation.
C) Myocardial infarction: Although anticoagulation may be warranted in the setting of a myocardial infarction, argatroban is not specifically indicated for this condition. Other antithrombotic therapies, such as aspirin or heparin, are more commonly used.
D) Hepatotoxicity: Argatroban is metabolized in the liver, so caution is warranted in patients with liver dysfunction. Hepatotoxicity itself would not be a reason to use argatroban; rather, it may require close monitoring or adjustment of dosage.
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Correct Answer is D
Explanation
A) Pancytopenia: While some medications can cause pancytopenia, it is not a common or direct side effect of alteplase. This condition involves a reduction in red blood cells, white blood cells, and platelets, and is not typically associated with thrombolytics.
B) Hypertension: Alteplase is not known to cause hypertension. In fact, the goal of administering alteplase in the context of a pulmonary embolism is to dissolve the clot and restore normal blood flow, which may help stabilize blood pressure.
C) Hypokalemia: This condition, characterized by low potassium levels, is not a common side effect of alteplase. There are other medications that may cause electrolyte imbalances, but alteplase itself is not typically linked to hypokalemia.
D) Internal bleeding: This is a significant risk associated with alteplase, as it is a thrombolytic agent that dissolves clots. The nurse should closely monitor for signs of internal bleeding, such as changes in vital signs, unexplained bruising, or blood in urine or stool. This is the most critical side effect to assess for in a client receiving alteplase
Correct Answer is D
Explanation
A) "This medication decreases chest pain by dissolving blood clots that are occluding the arteries.": This statement is incorrect because nitroglycerin does not dissolve blood clots. Instead, it works by relaxing and dilating blood vessels, which helps improve blood flow to the heart muscle and relieve angina.
B) "Place one tablet under your tongue every 15 minutes and repeat up to 5 times for relief of chest pain.": This is not accurate; while nitroglycerin can be taken sublingually, the typical recommendation is to take one tablet every 5 minutes as needed for chest pain, not every 15 minutes, and not to exceed 3 tablets within 15 minutes.
C) "This medication is the first-line treatment for hypertension.": Although nitroglycerin can lower blood pressure, it is not typically considered a first-line treatment for hypertension. It is primarily used for angina relief rather than as a primary antihypertensive agent.
D) "This medication dilates cardiac blood vessels to deliver more oxygen to the heart.": This statement accurately describes the action of nitroglycerin. By dilating the coronary arteries, nitroglycerin increases blood flow and oxygen delivery to the heart muscle, which helps alleviate angina symptoms. This is a key point to emphasize during patient education.